Author: Dr. Bryce Hendy, DC, DNCert
Have you ever been to a chiropractor before for low back pain and they have asked you about your sexual function? Ever thought to yourself, why is my chiropractor asking me about that, seems out of their wheelhouse. Well as much as your chiropractor is not going to manage a case of sexual dysfunction directly, the presence of sexual dysfunction may help guide the diagnosis of your low back pain.
Disc herniations have a wide range of symptoms and presentations. In some cases a herniated disc may present as low back and no other symptoms. For some people the symptoms are obvious and they experience shooting pain, numbness/tingling and weakness into their legs. For others the associated symptoms of a herniated disc may present as erectile dysfunction in males, and in females this can present as decreased desire, difficulty with arousal and lubrication or pain during intercourse.
When a lumbar disc herniation happens, the associated symptoms that come with this diagnosis are due to compression and irritation of the nerve roots in the lumbar and sacral regions. The nerve roots are the nerves that exit the spinal column (off the spinal cord) and travel into other parts of the body. In the case of sexual dysfunction, the nerve roots commonly affected are the S2-4 nerve roots. These nerve roots contribute to the sacral plexus (L4-S4), but more specifically give rise to the pudendal nerve. The pudendal nerve innervates the external genitalia, perineum and pelvic floor muscles. It provides sensory and motor function to these regions.
When the S2-4 nerve roots which make up the pudendal nerve are compressed by a herniated disc, it can present as sexual dysfunction as described above. It can also present as dysfunction of bowel emptying and bladder emptying. This is often why chiropractors will ask not only about sexual function, but also about bowel or bladder function. Since the pudendal nerve is located closer in proximity to the lumbar and sacral spine, this can sometimes be the first associated symptoms a patient will notice with a herniated disc.
So when your chiropractor asks about your sexual function and bowel/bladder function, this is to help them diagnose low back pain and help rule out possible disc herniations or other causes of nerve compression/irritation in the lumbar and sacral spines.
